Patients with cancer often lose weight. For some, it is one of the problems that that drives them to seek medical care. They may have no appetite and sometimes have lost a large amount of weight. This, along with abdominal pain, may be the main symptoms of a patient with abdominal (peritoneal) mesothelioma. In patients with pleural mesothelioma, the chest pain, coughing and shortness of breath will probably be the most troubling symptoms. But they, too, can already have lost a lot of weight before they get their diagnosis.
This means that even before treatment, patients with mesothelioma may be underweight and also low on important vitamins and nutrients. Every attempt must be made to try and correct this, as they go on to have treatment which may make their weight loss worse.
In order to heal, the body needs enough of many important nutrients. These include carbohydrates, protein, fats, water, vitamins and minerals.
Carbohydrates are a major source of fuel for your body. The best sources of carbohydrates come from whole grains, fruits and vegetables. These also have fiber, which helps regulate your bowel function, and also phytonutrients – vitamins and other chemicals that come specifically from plants. Whole wheat bread and pasta have more nutritional value than white bread and pasta, but both are better than getting carbohydrates from sugary sources like candy. The carbohydrate in
most soda and candy is simply sugar, which does not last very long as a source of energy.
The body needs protein to build many things. Protein is necessary for the body to do repairs, for the body to grow, and to strengthen immunity. Cancer patients need extra protein to fight the cancer, and also to heal after surgery or other treatment. Protein comes from animal sources, including beef, chicken and other meats, also fish and eggs. Milk products contain protein, as do soy products as well as nuts and beans.
The right kinds of fats are needed by the body. Fat is a source of energy. It is also the way the body stores extra energy, which also provides insulation from the cold. Most people prefer foods cooked with at least some fat. It is best to use unsaturated fats, including many vegetable oils. There are some polyunsaturated fats that the body cannot make, although they are necessary for cell building and hormone production. Linoleic acid and alpha-linolenic acid are essential fatty acids which must come from food. Some kinds of fats are not good for the body, including transfats and saturated fats, the amounts of which should be limited.
Vitamins and minerals are crucial for growth and repair. They are needed in order for the body to use ingested calories. Theoretically, a person can get all the vitamins and minerals needed by eating a balanced diet. Usually people with cancer cannot get enough of the nutrients through their diet. A person with mesothelioma may need a regular vitamin and mineral supplement daily. This should be discussed with the doctor and/or a dietitian. A dietitian can take a look at a person’s diet and figure out what is missing and the best way to get more of it.
There are alternative and complementary therapies based on megavitamin doses. It is best to discuss these with your doctor. Very high vitamin doses can be bad for the body and can even make chemotherapy and radiotherapy less effective.
Antioxidants are very popular supplements, and the foods which have antioxidants are touted as very healthy. It is true that antioxidants can protect the body from some kinds of damage. Fruits and vegetables are the best source of anti-oxidants, including blueberries and other berries, carrots, tomatoes, red grapes, and many others. A patient with mesothelioma may be best off not taking supplements of these chemicals (including vitamins E, C, A and selenium). Again, this can be discussed with the doctor or nutritionist.
All of the functions of the body depend on water. It is recommended that every person should drink 8 eight-ounce glasses of water or clear fluids a day.
Herbs are sometimes traditional remedies from other cultures, and also often part of complementary or alternative therapies. If a patient wants to undergo regular medical treatment and also use herbs, he or she should discuss this with the doctor, to make sure that the herbs will not endanger the patient or compromise the treatment.
Once you are diagnosed with cancer, you probably need to see a dietitian. It is important to try and correct any deficiencies before treatment begins, because most cancer treatment makes it even harder to eat and drink everything the body needs. In fact, the body needs more of everything to heal itself after surgery, chemotherapy or radiation therapy. So if you can, you should eat a healthy diet as much as possible before treatment.
You may want to anticipate your needs after treatment. If someone else is going to be doing the shopping and cooking, they need to be ready to feed you nutritious foods. If you usually cook, you can make foods you like best and freeze them for later use. Stock up on snacks, especially bland snacks that you usually have been able to eat in the past when you were sick.
You will need to eat foods high in protein and calories after your treatment. You can often add both by using milk products, nuts, and eating meats.
Milk shakes and other drinks that are high in calories and protein can be good if you are having trouble chewing and swallowing because of sores in your mouth.
Specifically after surgery and general anesthetic, it may take some time for your intestinal tract to start working. This will be even more of a problem if you have had abdominal surgery. There are medications that can help with pain and nausea, so be sure to tell your doctor your symptoms. After surgery there is usually a progression from sips of clear liquids, to more clear liquids, to easy to digest foods and eventually a normal diet. If you are not able to eat normally, you will need the help of a dietitian and your doctor to find ways to get you more calories.
With surgery of the chest, especially if it is a large procedure like an extrapleural pneumonectomy, in addition to pain, you may have feelings of fullness and shortness of breath when you try and eat.
Radiation therapy usually causes problems in the area being treated. If you have radiotherapy to the chest, you can have some discomfort related to the esophagus – the tube that brings food from your mouth to your stomach. It will get some of the irradiation and can have some damage, usually temporary. You can have pain on swallowing or heartburn. If this does not improve over time, your doctor will need to evaluate you further.
Just about everyone being treated with cancer will have fatigue as well as a reduced appetite. One problem just makes the other one worse.
Chemotherapy may be the treatment that makes eating the hardest. Essentially every medication causes nausea and vomiting. In addition, sores in the mouth or esophagus are common, causing pain with eating. Try to eat small snacks frequently. Ask your doctor or radiation therapist for advice. Meet with a dietitian to get other suggestions. Remember that there are medications to counteract nausea. There are food supplements to add calories and protein.
As you are getting treatment for your mesothelioma, and as you recover from surgery, chemotherapy and or radiotherapy, you need to give your body the nutrition it needs in order to help heal.
Dr. Kaplan
